Provider Demographics
NPI:1164280756
Name:DENTAL ARTS LLC
Entity Type:Organization
Organization Name:DENTAL ARTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYSA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-625-6300
Mailing Address - Street 1:95-1099 AINAMAKUA DR STE 1
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-4298
Mailing Address - Country:US
Mailing Address - Phone:808-625-6300
Mailing Address - Fax:808-623-6810
Practice Address - Street 1:95-1099 AINAMAKUA DR STE 1
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-4298
Practice Address - Country:US
Practice Address - Phone:808-625-6300
Practice Address - Fax:808-623-6810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment